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14420 SW 114TH AVENUE ADDRESS: a J CO LO W J i:lrecordsVnicroflrnitargelsVwifding.doc CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #. . . . . . . : P'I_M97-0179 13125 SW Hall Rlvd., Tigard,OR 97223 (503)639.4171 DATE ISSUED: 05/14/97 PARCEL: 2S1lVIAB-0 300 CITE ADDRESS. . . : 14420 SW 114TH AVE SUBDIVISION. . . . : COI-ES ACRES ZONING: R-4. 5 . . . . . . . . . . LOT. . . . . . . . . . . . . :9 JURISDICTION: T I G CLASS OF WORK. . :ALT GARBAGE DISPOSALS. : iD MOBILE HOME SPACES. : 0 'TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 0 OCCUPANCY GRP. . : R3 FLOOR DRAINS. . . . . . . 0 TRAPS. . . . . . . . . . . . . . . 0 SJORIES. . . . . . . . : Qi WATER HEATERS. . . . . : 1 CATCH BASINS. . . . . . . : 0 FIXTURES---- _—._.-------- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0 51NL:S. . . . . . . . . . 0 URINALS. . . . . . . . . . . . 0 GREASE: TRAPS. . . . . . . . 0 LAVATORIES. . . . : 0 OTHER, FIXTURES. . . . : 0 TUB/SHOWERS. . . : 0 SEWER LINE (ft ) . . . : 0 WATER CLOSETS. : 0 WA FFR LINE (f t ) . . . : 0 DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 0 Remarl(s : Installation of new water heater,. Owner: -______..____._.__.__._____•_________________._____._.. ..-•-.---.._---___-__ FEES IRIIhiNA ROGACHEZSKY type amol-int by date recpt 144.2'0 SW 114TH PRMT 'b 25. 00 DRA 05/14/97 97--294530 TIGARD OR 97224 5PCT 1. 215 DRA 05/14/97 97--294530 Phone #: Cont;r^act or---.__-___—•---•--_.________.___.._.__._.______...._ COLUMBIA HEATING P'0 BOX 30,-;97 8900 SW BURNHAM ST GTE E-110 T :IGARD OR 972bl--0:97 Phone fi : 624-12704 $ 26. 25 TOTAL Reg #. . 00076?, — - - -- _— REG O I RED INSPECTIONS This permit is issued subject to the regulations contained in the Misc. Inspection Tigard Municipal Code, State of Jre. Specialty Codes and all othc•, -i na l Inspection applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started _ within 180 days of issuance, or if work is suspended fcr more �. c- than 180 days. PermitteeS• n a t�a r e '1 I s s�_l e d By y . Cal ' for inspection — 639-4175 CITY OF TIGARD Plumbing Application Recd By 13125 SW HALL BLVD. Commercial and Residential Date Recd 5 IAF-57 TIGARD, OR 97223 Late to P E. (503) 639-4171 Date to DST Permit 0 P/�`?7-017 1 Print or Type Related SWR N Incomplete or illegible applications will not be accepted Called_ _ Name of Develop Project 7��j�(��/� FIXTURES (Individual) QTY PRICE AMT Job Ch�'e"""`7 Sink 9.00 Street Address Lavatory 9.00 Address suite _ _ i 14,7 C /�8 Tub or TublShower Comb. 9.00 Bldg s C /State ,�1 ZipShowerShower Only 9.00 _. /� 7 � Water Closet 9.00 Name _ (A Q.S 1 )�' Dishwasher 9.00 OWne- Maiiing Address Suite Garbage Disposal 9.00 Washing Machine 9.00 City/State Zip Phone Floor Drain 2' 9.00 Name 3" 9.00 5 Cc �- a' _ 9.00 Occupant Mading Address Suite Water Heater 9.00 Laundry Room Tray 9.00 City/State Zip Phone Urinal 9.00 —•---- Name Other Fixtures(Specify) 9 00 / _ )I 9.00 Contractor Mailing Address Suite- _ 9.00 3`^ 900 Ci /State Zip Phone �--- 9.00 �, OR 3 L--)1 Ore on Const.Cont Board Lic.0 Exp.Date 9.00 Attach Copy of (L9.00 Current Plumbing Lic.0 Exp.Date ba,Ner-1st 100' 30.00 Licenses 2 4 - 11-31-(,r"i Sewer each additional 100' 25.00 C T Business-Tax or Metro 0 Exp Date- NameWater Service- 1 st 100' 30.00 ~ �Jf Water Service each additional 200' 2500 ;architect Storm&Rain Drain-1st 100' 30.00 or Mailing Address Suite Storm&Rain Drain-each additional 100' 2500 Mobile Home Space 2500 Engineer City/Slate Zip Phone Commercial Back Flow Prev3ntion Device or Anti- 25.00 Pollution Device Descnbe work ^�New O Addition O Alteration O Repair O Residential Backflow Prevention Device. 1500 s to be done: Residential O Non-residential O Any Trap or Waste Not Connected to a Fixture 9.00 R Additional descr otion of work Catch Basin 9.00 nsp of Existing Plumbing a 40.00 y perth! _ Existing use of Specially Requested Inspections 4000 budding or propertyperthr Rain Drain.single family dwelling 30.00 LL proposed use of Grease Traps 9.00 --i building or property._ QUANTITY TOTAL I Aro you capping, moving or replacing any fixtures) Yes p No❑ Isornem d tnc or riser diagrais "uired Quanu dy Total >9 (If yes see back of form) _ 'SUBTOTAL I hereby acknowledge that I have read this application.that the„formation _ given is correct.that I am the owner or authorized agent of the owner,and 5% SURCHARGE / that plans s bmitted are in comp lance with Oregon Slate Laws Signa n PLAN REVIEW 25%wnorlA nt Date OF SU6TOTAL 4L _ ^ Roouved ony d rixture qty total is>9 TOTAL / rson Name--' Phone 7l /� 'Minimum permit'to is 525 • 5%surcharge.except Residential Backflow cCx_2 71 Prevention Device,which is S15-5%surcharge cldstsiplmapp.doc 8/96 PLEASE COMPLETE AS APPROPRIATE MPROJECT: Fixtures to be capped, moved or replaced Qty Sink _ Lavatory _ Tub or Tub/Shower Combination Shower Only _ Water Closet Ushwasher _ Gay bage Disposal _ Washing Machine F;oor Drain 2" 4" Water Heater - Laundry Room Tray _ Urinal _ Other Fixtures (Specify) COMMENTS REGARDING ABOVE: J G] - — ------------------------.___.—_..-------- — — �+._. r. c.D LLI ------ -- ---- ------- ------ —®---- _J i r CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Phone: 639-4171 Date Requested: 7 _ A.M. P.M. V MST: Location / rri 1 l �1�� BUR Tenant: Suite: _Bldg: MEC: 7-0/-Y-Z— Contractor: ti. -Phone: PLM: f!Lf-L 7/ ,"'' Owner: Phone: ELC: W,Si,fCFf ELR: 6 SIT: BUILDING BLDG(con't) MECHANICAL ELECTRICAL SITE Site Post/Bcam o. Scam Cover/Service Sewer/Storni Footing Roof UudFUSlab Ceiling Water Line Slab Framing Top Mt Pough-1n UG Sprinkler Foundation insulation Sewer rh-mf uct Rcc nnect Vault Bsmt Damp Drywall Stornn Furnace Temp Service MISC. Masonry Ceiling Fain£train A/C UG Slab Shear/Sheath Fire Spklr/Alm Crawl/Foruid Ih I lent 1'ruup Low Volt Approved Approved ua 1• Approved Approved Appr/Sdwlk Not Ap rp�vedV Not Approved oved Not Approved Not Approved -FINAL INAL / FINAL, FINAL SG ---- --- ----- ---_ __—�,. —--- -- J LL: O Call for ren n O Reinspection fee of S—_ _required befom next inspection 0 Unable to inspect Inspectar___ Date: _ Page of _ CITY CSF TIGARD DEVELOPMENT SERVICES ELECTRICAL PERMIT PERMIT #: ELC97-O34O 13125 S W Hall Blvd., Tigard,OR 97223 (503)639.4171 DATE ISSUED: 06/05/97 PARCEL: 251 1 OAP-O2af*_�O SITE ADDRESS. . . : 14420 SW 114TH AVE SUBDIVISION. . . . :COL.ES ACRES ZONING: R-4. 5 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :0 JURISDICTION: TIG Pro J ect Description : INSTL I BRANCH CIRCUIT // JOB t 523-084 ---RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS---- - ---MISCELLANEOUS------- 1000 SF OR L.ESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/I R R I GAT I ON. . . . : 0 EPCH ADD' L 5O0SF'. . . : 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0 LIMITF_D ENERGY. . . . . : 0 401 _. 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0 MANF. HM/ SVC/FDR. . : 0 601+amps--1000 volts. : 0 MINOR LAPEL ( 10) . . . : 0 ------SERVICE/FEEDER------ ------BRANCH C I RCIJ I TS------- ---ADD' L INSPECTIONS- -- 0 NSPECTIONS--- 0 - 200 amp. . . . . . .. 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0 `01 - 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 1 PER HOUR. . . . . . . . . . . : 0 401 - 600 amp. . . . . . 0 EA ADD' L BRNCH CIRC: 0 IN PLANT. . . . . . . . . . . : 0 601 - 1000 amp. . . . . : 0 ---------_.______ ._F'L.AN REVIEW SECT I CN--_---_-------_-.__-- 1000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VO' T NOMINAL. . : Reconnect only. . . . . : 0 SVC/FDR ) _ 225 AMPS. . : CLASS AREA/:,PEC OCC. : Owner: ------------•-------•----------------------------------- FEES IRINA ROGACHEZSKY type amoo.rnt by date recpt 14420 SW 114TH PRMT $ 35. O0 TAT or-,/O5/97 97-29554'1 TIGARD OR 97224 5PCT $ 1. 75 TAT 06/05/97 97-95'.544 Phone #: Contractor ------------------------------------------------------ ------------ WESTSIDE ELECTRIC $ 36. 75 TOTAL 7518 SW MACADAM AVE -- -- -- REQUIRED INSPECTIONS ------ PORTLAND OR 97219 Ceiling Cover Undergroi_rnd Cove Phone #: 245-3385 Wall Gover Eler_t' 1 Service Reg #. . . 000133 This permit is issued subject to the regulations cont lined in the -- Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm i t t g e i gnat t.tre applicable laws. All work will be done in accordance with I approved plans. This pewit will expire if work is not started within IN days of issuance, or if work is suspended for more than 180 days. I s s 1.r P y -----------------------.--------___.____gWNER INSTALLATION ONLY-- The installation is being made on property I own which is not intended for sal P, lease, or- rent. OWNER' S SIGNATURE: DATE: ------------------- -------CONTRACTOR INSTALLATION ONLY------------------------------ SIGNATURE -----------------------------SIGNATURE OF SUF'R. ELEC' N: ��'(... i_ DATE: � LICENSE NO: Call for inspection - 639-4175 Community Development ELECTRICAL PERMIT APPLICATION! 13125 SW Hal Blvd. / n Tigard, OR 51223 Permit # Date Issued _ Phone (503) 639-4171 CITY Of TICARD FAX (503) 684-7297 TDD No (503) 684-2772 Inspection (503) 639-4175 7. Job Address: 4. Complete Fee Schedule Below: Name of Development Number of Inspections per permit allowed AddressltlyZ� S� Service included Items Cost(ea) Sum City/State/Zip //� a _ 4a. Residential -per unit 1000 sq. ft. or less $110.00 _ 4 Each Name (or name of business) // ch additional — — �-- r portion thereof sq fl or $25.00 Commercial ❑ Residential Limited Energy $2500 _ 1 Esch Manufd Home or Modular Dwelling Service or Feeder $68.00 2a. Contractor installation only: / 4b. Services or Feeders Electrical Contr ctor ,f/ /C [CZN/ C Installation,alteration,or relocation 200 amps or less $6000 � Address _ An 1 -e 201 amps to 400 amps i $8000 — 2 401 amps to 600 amps $120.00 2 City h — State Zip _ 601 amps to 1000 amps E180 00 — 2 Phone No. — __ Over 1000 amps or volts $34000 2 t` Reconnect orly —_ $5000 2 contractor's license NO Z = 4c. Temporary services or Feeders Contractors Board Reg. NO _ L _ nstallation,alteration,or relocation Signature of Supr. Elec'n 200 amps or less 2 2 201 amps to 400 amps $"n')(1 License No. /1—TG Phone No Z Y� � 401 amps to 600 amps —_ 175 e0 2 Over 600 amps to 1000 volts $100 1-10 - 2b. For owner installations: see"b"above 4d. Branch Circuits Print Owner's Name_ _ New,alteration or extenslon per pane Address a)The fee for branch circuits with �— purchase or service or feeder fee. 2 City -----__-_-_ State--- Zip_______ Each branch circuit $5.00 Phone No. b)The fee for branch circuits without The installation lei being made on property I own v.`ich is purchase of service or feeder lw, not intended for sale, lease or rent. First branch circuit $35.00 Each additional branch circuit $5.00 - Owner's Signature �_- 4e. Miscellaneous (Service or feeder not included) 3. Plan Review section (if required): Each pump or Irrigation circle -- $4000 -- ' Each sign or outline lighting S4000 _ Signal circuh(s)or a limited energy Please check apprupriate Item and enter fee In section 5B. panel,alteration or extension $4000 4 or more residential units In one structure Minor Labels(10) $10000 Service and feeder 225 amps or more N System over 600 volts nominal 4f. Each additional Inspectlol. over �- Clarsified area or structure containing, special occupancy the allowable In any of the above as described In N.E.C. Chapter 5 Per Inspection i_ $3500 - Per hour $5500 J In Plant $5500 -- co Submit 2 sets of plans with application where any of the above C- apply. Not required for temporary cr.nlcruction services. 5. Fees: 5a. Enter total of above fees $ NOTICE 5%Surcharge (05 X to,al fees) $ — PERMITS BECOME VOID IF WORK OR CONSTRUCTION Pubtotal $ _ AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF 5b. Enter 25%of line A for CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $ A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS SuS�total $ COMMENCED. .�a�emn.a.g. g_ Trust Account 0 $ m m gqp _ Valance Due 73� CITY OF TIGARD ME:PERMITAL DEVELOPMENT SEnVICES PERMIT #. . . . . . . : MEC97-01 ,2 13125 SW Hall Blvd., 71gard,OR 97223 (503)639-4171 DATE ISSUED: 05/14/97 PARCF..i._.: ES110AB--02300 f:3:,TE ADDRESS. . . : 14420 EDW 114TH AVE_ SUBDIVISION. , . . : COLES ACRES ZONING: R--4. 5 IaLOCK. . . . . . . . . . 1_01.. . . . . . . . . . . . . :9 JURISDICTION: TIG CLASS OF WORK. . :ALT FLOOR FURN. . . . : 0 FVAP COOLERS: 0 TYPE OF USE. . . . :SF I_IN T T HEATERS. . : 0 VENT FANS. . . : 0 OCCUPANCY GRF'. . : R3 VENTS W/O APF'L: 0 VENT SYSTEMS: 0 STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0 FUEL_ TYPES-.------------ 0-3 I-IP. . . . : 0 DO11ES. INCIN: 0 —15 HP. . . . : 1Z1 COMML. I NC I N: 0 11A X INPUT: 0 BTU 15--30 HP. . . . : 0 RFPA I R UNITS: 0 FIRE DAMPERS?. . : 30-50 HP. . . . : 0 WOCDSTGVES. . : 0 GAS PRESSURE. . . : 50+ HP. . . . : 0 CLO DRYERS— : 0 NO. OF UNITS------------- A I P HANDLING UNITS OTHER UNITS. : 0 FURN ( 100K BTU: 0 (= 10000 cfm : 0 GAS OUTLETS. : 1 FURN ? =100K BTU: Qi > 10000 cfm : 0 Remarks : Gas piping for new water heater. Owner: _________.__.._--.-.--.._______.-----______.-_______._____.____._.__-._-- FEES ---- -- -- --- -- IRIMNA ROGACHEZSKY type amorant by date rer- t 14420 SW '114TH PRMT $ 25. 00 DRA 05/14/97 '37--;:94531 TIGARD OR `37214 5PCT $ t. 25 DRA 05/14/97 97•-294531 Phone #: CUTItY'a(-`t(Jr': _------------ --___________ __-- COLUIhBIA HEATING & COOLING INC PO BOX c'30397 TIGARD OR 97223 P i c)n e #: 624-2704 $ 26. 25 TOTAL_ Reg #. . : 00076 ------•- REQUIRED INSPECTIONS ---- --- This permit is issued subject to the regulations contained in the Gaa Line [nsp Tigard Municipal Code, State of Ore. Specialty Codes and all other hlechan i c a:. I n s p _ applicable laws. All work will be done in accordance with Misr-. Inspec,tion approved plans. This permit will expire if work is not started Final Inspection within 180 days of issuance, or if work is suspended for sore _ f than 180 days. J J Permittee F-ignatt_rre : Qne a 44 I s S".1 e d \ Call for- inspection - 639-4175 Plan Che CITY OF TIGARD Mechanical Permit Application Recd ByL 113125 SW HALL ELVD. Commercial and Residential Date Recd TIGARD, OR 97223 Date to P.E. (503) 639-4171, x304 Date to DST_, ? Print or Type Permit# ' 'c0_9-7-Dr a- Incomplete or illegible applications will not be accepted Called - - Name of DevelopmenvPr Description 12 . ( C-17e2nil<v Table 1A Mechanical Code qTY RICE A'dT Job Street Address Suite# A) Permit Fee 0- 0- 10.00 Address t ?i) 5W _ Bldg# C State Zip B) Supplemental Permit 3.00 Name for name of business) /�1 1.) Furnace to 100,000 BTU 6.00 Owner err. e, Q 5 Q b��C/ incl.ducts&vents Mailing Address 2.) Furnace 100,000 BTU+ 7.50 incl ducts&vents City/Stale Zip Phone 3) Floor Furnace 600 incl vert Name(or r ame of business) 4.) Suspended heater,wall heater 6.00 u floor mounted hcdter Occupant "-;ling Address 5) Vent not incl.in 3.00 appliance_permit Cily)State Zip Phone 6) Boiler or comp,heat pump,air cond. 600 to 3 HP. absorp unit to 100K BTU N e 7.) Boder or comp,heat pump,air cond. 11,00 1 _ 3-15 HP,absorp unit to 500K BTU _ Contractor ailing address 8) Boller or comp,heat pump,air cond 15,00 15-30 Hr absorp unit.5-1 mil BTU A.tt?cn copy of c t'tale Zip Phone 9.) Boiler or camp,heat pump,air cond. 22.50 Current Licenses , )[' L vq 30-50 HP,absorp unit 1-1.75 mil BTU _ OregriA Const.Cont Board Lie# Exp Date 10) Boiler or comp,heat pump,air cond 37 50 -' /0- - =50 HP:absorp unit 1.75 mil BTU C T in Tax or tro# Exp Date 1 1 ) Air handling unit t0 4.50 �`�- -j - 10,000 CFM _ _ Architect Name 12) Air handling unit 7.50 10,000 CTM+ or Mailing Address 13) Non portable 4 50 evaporate cnoter Engineer cityistate Zip I Phone — 14.) Vent fan connected 3.00 to a single duct Describe work New O Addition O Alteration O Repair O 15) Ventilation system not 4.50 to be done Residential O Non-residential O included in appliance permit _ Additional Description of work 16) Hood served by mechanical exhaust 4,50 /u1G�Y E_ 17) Domestic incinerators - 750 Ekt ting use of 18! Commercial or industrial 30.00 budding or property _ type incinerator 19) Clothes dryers,etc 4 50 n: H Proposed use of 20) Other units 4.50 building or property -a Type of fuel-oil O nkural gas O LPG O electric O 21) Gas piping one to four outlets 200 00 c. I hereby acknowledge that I have read this application,that the 22) More than 4-per outlet (each) 50 0 information given is correct,that I am the owner or authorized agent of -j the owner,that plans submitted are in compliance with Oregon State QTY.SUBTOTAL laws Signature of ner/Agent Date 'SUBTOTAL �C1 r 5%SURCHARGE f1l onMct on Name f 6phone PLAN REVIEW 25%OF SUBTOTAL L'i� - __ TOTAL i%dstVnechpmt.doc Minimum permit fee is$25+ 51/:surcharge Rev 7/96 Lj